Provider Demographics
NPI:1265685598
Name:LUCIA, JENIFER LORRILL FARINA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JENIFER
Middle Name:LORRILL FARINA
Last Name:LUCIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3403 RED COAT DR
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-4935
Mailing Address - Country:US
Mailing Address - Phone:610-883-7694
Mailing Address - Fax:
Practice Address - Street 1:60 MERRITT BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-2990
Practice Address - Country:US
Practice Address - Phone:845-905-5091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014352363A00000X
CT002172363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant